EXERCISES FROM (Buck’s Step-by-Step Medical Coding, 2021 Edition)

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EXERCISE 16-1 (Buck’s Step-by-Step Medical Coding, 2021 Edition) Endoscopy Using the CPT and manual, complete the following: 1 Endoscopic maxillary antrostomy CPT Code: _____ 31256 _______________ 2 Direct laryngoscopy for removal of fish bone CPT Code: ____ 31530 ________________ 3 After the airway is sufficiently anesthetized, a flexible bronchoscope is inserted through the mouth and advanced to the bronchus, where a transbronchial biopsy of one lobe is obtained. CPT Code: _____ 31628 _______________ 4 Diagnostic thoracoscopy of the mediastinal space is accomplished with the use of a flexible endoscope that is inserted through a small incision on the chest (no biopsy was performed). CPT Code: ____ 32601 ________________ 5 Segmental resection of the right single lung lobe using a flexible endoscope (surgical thoracoscopy) CPT Code: _____ 32663 _______________ EXERCISE 16-2(Buck’s Step-by-Step Medical Coding, 2021 Edition) Nose Using the CPT and ICD-10-CM manuals, complete the following: 1 Biopsy of an intranasal lesion CPT Code: _______ 30100 _____________ ICD-10-CM Code: ________________ 2 Primary rhinoplasty including major septal repair due to deviated nasal septum, acquired CPT Code: ______ 30420 ______________ ICD-10-CM Code: ________________

3 Anterior control of nasal hemorrhage by means of limited chemical cauterization and simple packing CPT Code: ______ 30901 ______________ ICD-10-CM Code: ________________ 4 Septoplasty with contouring and grafting CPT Code: _______ 30520 _____________ 5 Removal of crayon from nose of 5-year-old boy, conducted as an office procedure CPT Code: ____ 30300 ________________ EXERCISE 16-3(Buck’s Step-by-Step Medical Coding, 2021 Edition) Accessory Sinuses Using the CPT and ICD-10-CM manuals, complete the following: 1 Lavage of the maxillary sinus, bilateral CPT Codes: ____ 31000 ________________ and ______ 31000-50 ______________ 2 Simple left frontal sinusotomy using an external approach CPT Code: ____ 31070-LT ________________ 3 Unilateral sinusotomy of frontal, ethmoid, and sphenoid CPT Code: _____ 31090 _______________ 4 Right radical maxillary sinusotomy CPT Code: ______ 31030-RT ______________ 5 Pterygomaxillary fossa surgery, transfacial approach, due to chronic antritis of maxillary sinus CPT Code: ____ 31040 ________________ ICD-10-CM Code: ________________ EXERCISE 16-4(Buck’s Step-by-Step Medical Coding, 2021 Edition) Larynx

Using the CPT and ICD-10-CM manuals, complete the following: 1 Laryngotomy CPT Code: _______ 31300 _____________ 2 Laryngoplasty, two stages, for repair of congenital laryngeal web, removal of spacer CPT Code: ______ 31580 ______________ 3 Emergency establishment of positive airway by means of endotracheal intubation CPT Code: ____ 31500 ________________ 4 Subtotal supraglottic laryngectomy with removal of adjacent lymph nodes and tissue due to a primary malignant neoplasm of glossoepiglottic folds CPT Code: ______ 31368 ______________ ICD-10-CM Code: ________________ 5 Pharyngolaryngectomy with radical neck dissection for a primary malignant neoplasm of pharyngeal region CPT Code: _____ 31390 _______________ ICD-10-CM Code: ________________ EXERCISE 16-5(Buck’s Step-by-Step Medical Coding, 2021 Edition) Trachea and Bronchi Using the CPT and ICD-10-CM manuals, complete the following: 1 Emergency tracheostomy, cricothyroid approach CPT Code: ______ 31605 ______________ 2 Excision of a tumor of the trachea, cervical CPT Code: _____ 31785 _______________ 3 Catheterization with bronchial brush biopsy (code only the biopsy) CPT Code: _____ 31717 _______________

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4 Planned tracheostomy in 47-year-old patient with acute respiratory failure CPT Code: _____ 31600 _______________ ICD-10-CM Code: ________________ 5 Catheterization with bronchial brush biopsy for bronchiolitis, acute CPT Code: ______ 31717 ______________ ICD-10-CM Code: ________________ EXERCISE 17-1(Buck’s Step-by-Step Medical Coding, 2021 Edition) Coding Highlights Complete the following: 1 This term means entering the body: ______ invasive _______________ 2 A cardiologist is a(n) _____ internal ________________ medicine physician who has chosen to specialize in the diagnosis and treatment of conditions of the heart. 3 What three sections of the CPT will you often use to code cardiology services? _____ medicine ___________, ______ surgery __________, and ________ radiology _____________ 4 What type of cardiology enters the body—breaks the skin—to make a correction or for examination? _____ interventional ________________ 5 What is the term that describes the study of the electrical system of the heart and includes the study of arrhythmias? ____ electrophysiology _________________ 6 Physician who specializes in _______ nuclear ______________ cardiology uses radioactive radiologic procedures to aid in the diagnosis of cardiologic conditions. (Answers are located in Appendix B) EXERCISE 17-2(Buck’s Step-by-Step Medical Coding, 2021 Edition) Pericardium, Cardiac Tumors, and Pacemakers Using the CPT and ICD-10-CM manuals, code the following:

1 Allen Jackson gets very tired walking up and down stairs. He has a hard time catching his breath and experiences instances when his heart feels as if it is beating fast. His physician has told him that he will require a pacemaker implantation. Allen goes to surgery and has a single-lead pacemaker implanted with a ventricular lead. CPT Code: _______ 33207 _____________ 2 Five days after the pacemaker is implanted, Allen (from Question 1) feels very dizzy and his electrocardiogram is showing some abnormalities. His physician returns him to the operating room and discovers that the pacemaker lead is malfunctioning. The pacemaker lead is replaced, and Allen recovers nicely. CPT Code: ______ 33216-78 ______________ 3 Five years later, the battery in Allen’s pacemaker is found to have become depleted. He is also having some other symptoms that his physician believes necessitate not only a replacement pacemaker, but also an upgrade to a dual-lead device. CPT Code: ____ 33214 ________________ 4 A new patient with a chief complaint of sharp, intermittent retrosternal pain that is reduced by sitting up or leaning forward is evaluated by a cardiologist. Chest films reveal acute pulmonary edema with acute pericardial effusion. The physician performs a pericardiocentesis. (Code the procedure and diagnoses.) CPT Code: _____ 33016 _______________ ICD-10-CM Codes: ________________, ____________________ 5 Resection of an endocardium primary malignant tumor in which cardiopulmonary bypass is required CPT Code: ______ 33120 ______________ ICD-10-CM Code: ________________ (Answers are located in Appendix B) EXERCISE 17-3(Buck’s Step-by-Step Medical Coding, 2021 Edition) EP, Event Recorder, and Valves Using the CPT and ICD-10-CM manuals, code the following: 1 Mary Black’s echocardiogram and cardiac catheterization show severe mitral stenosis with regurgitation. Her physician believes that because she is symptomatic, she should have her mitral valve replaced. The mitral valve replacement includes cardiopulmonary bypass.

CPT Code: ____ 33430 __________________ 2 Andrew Nelson has a loud heart murmur and, after study, is found to have severe aortic stenosis. He elects to have an aortic valve replacement. He is taken to the operating room and placed on a heart-lung machine. He then has his aortic valve replaced with a prosthetic valve. CPT Code: ____ 33405 __________________ 3 With the heart exposed through the sternum and the patient’s functions supported by a cardiopulmonary bypass, the right atrium is opened and the bigeminal arrhythmia foci are ablated by using electrical current. Bypass is discontinued and the atrium and sternum are closed in the usual fashion. CPT Code: _____ 33261 _________________ NO APARECE EN SECUENCIA EN EL LIBRO ICD-10-CM Code: __________________ 4 Insertion of permanent leadless pacemaker of the right ventricle with imaging guidance for a diagnosis of palpitations and dizziness. CPT Code: _____ 33274 _________________ ICD-10-CM Codes: __________________, __________________ (Answers are located in Appendix B) EXERCISE 17-4(Buck’s Step-by-Step Medical Coding, 2021 Edition) Coronary Artery Bypass Using the CPT and ICD-10-CM manuals, code the following: 1 Two coronary bypass grafts using veins only CPT Code: ___ 33511 _______________ The code for Question 1 came from the category Venous Grafting Only for Coronary Artery Bypass because the bypass was accomplished using a venous graft. If the bypass had been accomplished using an arterial graft, the codes in the category Arterial Grafting for Coronary Artery Bypass would be used to report the service. If both veins and arteries were used to accomplish the bypass, you would report the service by reporting an artery bypass code and a code from the category Combined Arterial-Venous Grafting for Coronary Bypass. Because the title of the category contains the words “arterial-venous,” you might think that the codes in the category report both the artery and the vein, but this is not the case. The category codes under “arterial-venous” are used only when a venous graft has been used in addition to an arterial graft, and these arterial-venous codes are used only in combination with the arterial graft codes (33533-33536).

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For example, a patient has had a five-vessel coronary artery bypass graft, for which two bypasses were accomplished using internal mammary arteries and three bypasses were accomplished using veins (reported with 2A and 2B): 2A Coronary artery bypass using two arterial grafts CPT Code: ______ 33534 ______________ 2B Coronary artery bypass using three venous grafts in addition to the arterial grafts for coronary artery disease, native arteries, due to arteriosclerotic coronary heart disease CPT Code: _______ 33519 _____________ ICD-10-CM Code: ________________ 3 Coronary artery bypass of native arteries using one internal mammary artery graft and three venous grafts. Patient has documented arteriosclerotic coronary heart disease and hypertensive heart disease, benign. CPT Codes: ______ 33533 ______________, _____ 33519 _______________ ICD-10-CM Codes: ________________, ________________ (Answers are located in Appendix B) EXERCISE 17-5(Buck’s Step-by-Step Medical Coding, 2021 Edition) Embolectomy/Thrombectomy Using the CPT and ICD-10-CM manuals, code the following: 1 Thrombectomy of the aortoiliac artery, by leg incision CPT Code: _____ 34201 _______________ 2 Embolectomy, carotid artery, by neck incision CPT Code: _______ 34001 _____________ 3 Thrombectomy of venous bypass graft, postop complication, initial visit CPT Code: _____ 35875 _______________ ICD-10-CM Code: ________________

(Answers are located in Appendix B) EXERCISE 18-1(Buck’s Step-by-Step Medical Coding, 2021 Edition) Hemic and Lymphatic Systems Using the CPT and ICD-10-CM manuals, code the following: 1 Excision of an axillary cystic hygroma, which the patient medical record indicates involved no deep neurovascular dissection CPT Code: ______ 38550 ______________ ICD-10-CM Code: ________________ 2 Total removal of the spleen due to Gaucher’s splenomegaly CPT Code: ___ 38100 _________________ ICD-10-CM Code: ________________ 3 Injection procedure for a radiographic view of the portal vein of the spleen CPT Code: ____ 38200 ________________ 4 Bone marrow transplant, autologous CPT Code: _____ 38241 _______________ EXERCISE 18-2(Buck’s Step-by-Step Medical Coding, 2021 Edition) Mediastinum and Diaphragm Using the CPT and ICD-10-CM manuals, code the following: 1 Exploratory mediastinotomy with biopsy of mediastinal lesion accomplished with approach through the neck. Pathology report later indicated primary, malignant neoplasm.

CPT Code: _____ 39000 _______________ ICD-10-CM Code: ________________ 2 Resection of benign tumor of the mediastinum CPT Code: ____ 39220 ________________ ICD-10-CM Code: ________________ (Answers are located in Appendix B) CHAPTER REVIEW Theory Complete the following: 1 What is the muscle that separates the thoracic and the abdominal cavities? _______ diaphragm _________________ 2 The spleen initiates an immune response, filters and removes ____ bacteria ________ from the bloodstream and destroys worn out blood cells. 3 Total or partial splenectomy codes are designated in the CPT manual as ____ separate ________ procedures. 4 A marrow or ___ blood cell _________ (two words) transplant is a treatment for patients with blood diseases, such as leukemia or lymphoma. 5 A bone marrow ___ aspiration _________ is a procedure in which a sample of bone marrow is taken by means of a needle that is inserted into the marrow cavity. 6 A(n) ___ allogenic _________ bone marrow comes from a close relative. 7 A(n) ___ autologous _________ bone marrow comes from the patient, is processed, and later transplanted or reinfused. 8 A(n) ___ limited _________ lymphadenectomy is the removal of the lymph nodes only. 9 The Mediastinum category of codes is based on the __ surgical approach _______________ (two words) taken to perform the mediastinotomy. 10 Another name for the diaphragmatic nerve is the ___ phrenic _________ nerve. (Answers are only available in the TEACH Instructor Resources on Evolve)

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CHAPTER REVIEW Practical Code the following cases (Separate multiple codes with a comma and then a space in your response. XXXXX, XXXXX. Make sure to include a dash in front of your modifier answers. XXXXX-XX. Make sure to indicate units with an x and spaces. XXXXX x X): 1 Using a cervical approach, ligation of the thoracic duct was accomplished. CPT Code: _____ 38380 _______________ 2 Surgical laparoscopy with bilateral total pelvic lymphadenectomy CPT Code: ____ 38571 ________________ 3 Superficial inguinofemoral lymphadenectomy with pelvic lymphadenectomy, including the external iliac, hypogastric, and obturator nodes CPT Code: ____ 38765 ________________ 4 Diaphragmatic resection of a secondary, malignant lesion that included extensive use of prosthetic material. The primary malignancy was located in the uterus, which has been previously removed, followed by a course of radiation and chemotherapy with no further evidence of existence. CPT Code: ___ 39561 _________________ ICD-10-CM Codes: ____________, ____________ 5 Excisional biopsy of superficial lymph nodes of the neck by means of an open procedure for non- Hodgkin lymphoma CPT Code: _____ 38500 _______________ ICD-10-CM Code: ________________ 6 Dissection of the deep jugular nodes, diagnosis of thyroid gland primary cancer CPT Code: _____ 38542 _______________ ICD-10-CM Code: ________________ 7 Excision of congenital cervical cystic hygroma with dissection of deep neurovascularity CPT Code: ______ 38555 ______________ ICD-10-CM Code: ________________ 8 Limited lymphadenectomy for staging of para-aortic lymph nodes in malignant primary prostate cancer CPT Code: ______ 38562 ______________

ICD-10-CM Code: ________________ 9 Injection procedure for lymphangiography of axillary node enlargement, left side CPT Code: ____ 38790-LT ________________ ICD-10-CM Code: ________________ 10 Mediastinoscopy with biopsy for mediastinal mass CPT Code: ___ 39401 _________________ ICD-10-CM Code: ________________ (Answers are only available in the TEACH Instructor Resources on Evolve) CHAPTER REVIEW Learning Objectives Review the Chapter Learning Objectives located at the beginning of the chapter, then answer the following questions that relate to each objective (Answers are located in Appendix C): 1 The Hemic and Lymphatic Systems subsections include ____ Spleen ________, __ General and Lymph Nodes _________, and ___ Lymphatic _________ ____ Channels ________. 2 What system is considered a transportation system for interstitial fluids, proteins, and fat? ______ Lymphatic ____________________ 3 During a complete neck dissection, the lymph nodes in __________ Five ________ regions are removed. 4 The area between the lungs is called the ________________ Mediastinum ______________________________________________. 5 The difference between the mediastinotomy codes is the ____ Surgical _____________________ ______ Approach ___________________. 6 The mediastinoscopy code includes any ___________ Biopsy ____________________________ performed during the procedure. (Answers are located in Appendix C) CHAPTER REVIEW Glossary

Complete the following with the correct glossary term (Answers are located in Appendix C): 1 Area between the lungs that contains the heart, aorta, trachea, lymph nodes, thymus gland, esophagus, and bronchial tubes. ____________________________________ 2 Endoscope that is inserted through a small incision to view the mediastinum. ____________________________________ ________________________________ 3 Excision of a lymph node or nodes. _______________________________________ 4 Immature blood cell. ___________________________________________________ 5 Radiographic procedure to allow visualization of the splenic and portal veins of the spleen. _____________________________________________________________ (Answers are located in Appendix C)

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EXERCISES FROM (Buck’s Step-by-Step Medical Coding, 2021 Edition)

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